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Trichomoniasis Testing

Trichomoniasis (often called “trich”) is a common sexually transmitted infection (STI) caused by the single-cell parasite Trichomonas vaginalis. The parasite spreads when a person with the infection has unprotected sexual contact with an uninfected individual. Trichomoniasis can also spread from sharing sex toys that were not thoroughly cleaned between uses or touching a person’s genitals with infected fluids on the hands.

What is trichomoniasis?

According to the Centers for Disease Control and Prevention (CDC), more than two million people in the United States get trichomoniasis each year. However, the CDC notes that only around 30% of people with the infection ever develop symptoms. A sexually active man can transmit trichomoniasis to a woman and vice versa; the infection can also spread through vulva-to-vulva contact. The CDC notes that women are more prone to trich than men, and older women tend to be more susceptible to the infection than younger females.

In both sexes, trichomoniasis most commonly exists within the lower genital region. In women, it typically infects the urethra, cervix, vagina, or vulva, and in men, it usually infects the urethra. It’s uncommon for trichomoniasis to spread to body parts outside of the genital area, such as the anus or mouth.

Who should get a trichomoniasis test?

If you believe you may have come in contact with Trichomonas vaginalis during unprotected sexual contact, you should get tested for trichomoniasis. If you are a woman with HIV, the CDC also recommends that you undergo routine annual trichomoniasis screening, as co-infection can increase your risk of health complications. You should also get screened for the infection if you have new or multiple sexual partners, have a history of STIs, or are pregnant.

Like several other sexually transmitted diseases, trich doesn’t always cause noticeable symptoms—roughly 70% of people with the infection don’t know they have it, according to CDC data. However, asymptomatic individuals can still transmit the infection to others, as it is highly contagious.

If you believe you’re suffering from symptoms of the infection, you should take a trichomoniasis test as soon as possible. Getting a prompt diagnosis and appropriate medical treatment is the best way to prevent long-term health complications that an untreated infection can cause.

According to the CDC, it’s unclear why some people develop signs of trichomoniasis and others do not. When the infection does cause symptoms, it can manifest as mild irritation and discomfort or severe inflammation and pain, depending on the person. If you develop symptoms, they may begin to appear within five to 28 days after exposure to the parasite. However, symptoms can take weeks or even months to become noticeable.

Symptoms of trichomoniasis in women

According to the National Institutes of Health, a woman with a symptomatic trichomoniasis infection may notice:

  • Grayish or greenish vaginal discharge that may appear foamy, watery, or thick and have a strong, fishy odor
  • Pain while urinating
  • Vaginalor vulvar itching, irritation, or inflammation
  • Pain or discomfort while having sexual intercourse
  • Inflammation, burning, or soreness in the genital area that may also affect the inner thighs

Symptoms of trichomoniasis in men

According to the National Institutes of Health, men with trichomoniasis don’t typically have symptoms. However, a man with a symptomatic infection may notice:

  • Penis irritation, itching, or swelling, especially around the head or foreskin
  • Abnormal, watery, white discharge from the penis
  • Pain while urinating or with ejaculation
  • An unusually frequent urge to pee

Because trichomoniasis symptoms are often mild and similar to symptoms of several other STIs, the infection is difficult to diagnose without a genital exam and lab testing. Individuals with mild symptoms may mistake the infection for other common conditions such as a yeast infection or urinary tract infection. Sometimes, when symptoms are very mild, people ignore them altogether. According to the CDC, trich can last for several months or even years with no symptoms, and without treatment, it may cause long-term health issues.

How to get a trichomoniasis test

You can get a trichomoniasis test from a healthcare provider who will diagnose the infection with a genital exam and lab testing. Most urgent care clinics can perform trichomoniasis testing and accept walk-in patients for same-day, immediate care. You can also order an at-home trichomoniasis test kit online that will require you to take a urine sample or genital swab that you’ll mail to a lab for analysis.

How to prepare for trichomoniasis testing

According to the National Institutes of Health, trichomoniasis testing doesn’t involve any special preparation. But before you undergo testing, it’s a good idea to:

  • Avoid having sex (you should always avoid sexual contact if you think you may have an STI or have symptoms of an infection)
  • Avoid douching for at least 24 hours before taking a test, as douching can wash away the vaginal cells and/or fluids required for the test
  • Avoid using deodorant products or cleansers on your genital area, as such products can worsen irritation and mask signs that help your doctor diagnose the infection

If you’re a woman, the NIH recommends trying to schedule in-office trichomoniasis testing when you don’t have your period. If you’re taking an at-home test that requires a vaginal swab, it’s best to perform the swab when you’re not menstruating, in accordance with the testing kit’s instructions.

What to expect during a trichomoniasis test

According to the National Institutes of Health, your doctor may perform a few different types of trichomoniasis tests, depending on your gender.

If you’re a woman, your healthcare provider will perform a pelvic exam to look for signs of the infection, such as patchy red spots. Your provider will also use a swab to gently collect a sample of cells and/or discharge from your vagina. That sample will then be sent to a lab for analysis, where a professional will view it under a microscope to look for the Trichomonas vaginalis parasite. If microscopic analysis cannot identify the parasite, the lab may culture the sample for further analysis.

If you’re a man, your doctor will perform a visual exam of your genitals to look for signs of the infection. Your provider will likely also use a swab to collect a sample of cells from your urethra, which will be examined under a microscope to confirm the presence of the parasite.

The least invasive type of trichomoniasis test a doctor can perform is a urine test, which both women and men can take. This test will require you to collect a one- to two-ounce clean catch sample of urine that your provider will either test at the office or send to a lab for analysis.

Testing positive for trichomoniasis

The NIH notes that if your test comes back positive, you have a trichomoniasis infection and will need to undergo treatment. Your healthcare provider will prescribe a course of medication that will treat the infection and cure any symptoms you may be experiencing. Be sure to contact anyone whom you may have exposed to the infection to let them know you tested positive. Your sexual partner(s) should also undergo testing and treatment if they haven’t already done so.

According to the National Institutes of Health, the medication prescribed for trichomoniasis treatment can cause side effects, most commonly nausea, stomach pain, and vomiting. You should avoid drinking alcohol while taking the medication, as it can make these side effects worse.

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  1. Trichomoniasis — CDC Basic Fact Sheet (April 25, 2022)
  2. Sexually Transmitted Infection Treatment Guidelines, 2021, Trichomoniasis (July 22, 2021)
  3. Trichomoniasis Test (September 9, 2021)
  4. Rapid and point-of-care tests for the diagnosis of Trichomonas vaginalis in women and men (December 10, 2017)

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